Mental Health Nursing Exam 2026/2027: 80
NCLEX-Style Questions with Answers &
Rationales for Psychiatric Nursing Students
Description:
Master psychiatric mental health nursing with 80 original NCLEX-style questions for
2026/2027. Includes bipolar disorder, schizophrenia, eating disorders, substance use,
personality disorders, pharmacology, therapeutic communication, and legal ethics.
Each answer includes detailed clinical rationales.
Download the complete exam paper now and pass your mental health nursing certification on
the first attempt.
, NCLEX Mental Health Exam 2026/2027: 80 Questions &
Answers
Section 1: Therapeutic Communication and Active Listening
Question 1
A nurse is communicating with a client in an inpatient mental health facility. Which of the
following actions by the nurse demonstrates the use of active listening?
A. Offering self
B. Use of silence
C. Attention to body language
D. Reflection of feelings
Answer: C
Explanation: Active listening involves fully concentrating on, understanding, and
responding to a speaker. Attention to body language is a core component of active listening,
as it allows the nurse to observe nonverbal cues that convey meaning beyond spoken words.
Offering self, using silence, and reflecting feelings are therapeutic communication techniques
but do not specifically define active listening.
Section 2: Bipolar Disorder and Initial Assessment
Question 2
A nurse on a mental health unit is admitting a client who has bipolar disorder. Complete the
following sentence by using the list of options.
The first action the nurse should take is to address the client's __________ due to the client's
__________.
First blank options: Urine output; Cardiovascular injury; Noncompliance with medication
therapy; Inability to focus
Second blank options: Pressured speech; Poor recall of last food intake; Constant
psychomotor activity; Lithium level
Answer: The first action the nurse should take is to address the client's cardiovascular
injury due to the client's constant psychomotor activity.
Explanation: In a client with bipolar disorder experiencing mania, constant psychomotor
activity can lead to exhaustion, dehydration, and potential cardiovascular injury or collapse.
,This physiological safety concern takes priority over psychosocial assessments. The nurse
must first address physical safety risks before proceeding with other admission tasks.
Section 3: Trauma-Informed Care and Client Teaching
Question 3
A nurse at an inpatient mental health facility is caring for a client who recently experienced a
traumatic event. The nurse is providing teaching to the client. Which of the following
statements should the nurse include in the teaching? (Select all that apply.)
A. "A support group might be helpful to you at this time."
B. "You will have minimal problems performing your daily self-care tasks."
C. "It is uncommon for people who survived a traumatic event to experience spiritual
distress."
D. "You should seek help if you have thoughts of self harm."
E. "It is common for people who survived a traumatic event to experience feelings of
anxiety."
Answer: A, D, E
Explanation: Support groups provide validation and shared coping strategies. Seeking help
for self-harm thoughts is a critical safety intervention. Anxiety is a common psychological
response to trauma. Statements B and C are incorrect because trauma frequently disrupts
daily functioning and may precipitate spiritual distress.
Section 4: Legal and Ethical Considerations in Mental Health
Question 4
A charge nurse is preparing an educational session for a group of newly licensed nurses to
review client rights under the law. Which of the following statements should the nurse make?
A. "Information regarding clients should remain confidential until after their death."
B. "Failure to report suspected maltreatment or neglect of a disabled adult is a felony in all
states."
C. "As long as client identity is disguised, their health information can be shared between
professionals on the internet."
D. "In the event a client threatens harm to others, medications can be administered without
consent."
, Answer: B
Explanation: Mandatory reporting laws in all US states classify failure to report suspected
abuse or neglect of vulnerable adults as a criminal offense, often a felony. Confidentiality
extends beyond death in most jurisdictions. Disguising identity does not permit unrestricted
online sharing of health information under HIPAA. Medications cannot be administered
without consent except in specific emergency situations, not merely for threats.
Section 5: Pharmacological Management of Schizophrenia
Question 5
A nurse is reviewing the electronic medical record of a client who has schizophrenia and is
taking clozapine. Which of the following findings is the priority for the nurse to identify to
notify the provider?
A. The client's chart indicates a 1.36 kg (3 lb) weight gain in 1 month
B. The client reports an inability to breathe easily
C. The client's laboratory results indicate a fasting blood glucose level of 130 mg/dL (74 to
106 mg/dL)
D. The client reports having recently started smoking cigarettes
Answer: B
Explanation: Difficulty breathing may indicate clozapine-induced myocarditis or
cardiomyopathy, which are life-threatening adverse effects requiring immediate provider
notification. While weight gain, hyperglycemia, and smoking (which reduces clozapine
levels) are important concerns, respiratory symptoms represent the highest priority due to
potential rapid deterioration.
Section 6: Anorexia Nervosa – Evaluation of Improvement
Question 6
A nurse is caring for a client who has anorexia nervosa. The nurse is evaluating the client
after 2 weeks. Which of the following findings indicate an improvement in the client's
condition? (Select all that apply.)
A. Bowel movement
B. Blood pressure
C. Peripheral edema
D. Skin temperature
E. Blood urea nitrogen (BUN)
NCLEX-Style Questions with Answers &
Rationales for Psychiatric Nursing Students
Description:
Master psychiatric mental health nursing with 80 original NCLEX-style questions for
2026/2027. Includes bipolar disorder, schizophrenia, eating disorders, substance use,
personality disorders, pharmacology, therapeutic communication, and legal ethics.
Each answer includes detailed clinical rationales.
Download the complete exam paper now and pass your mental health nursing certification on
the first attempt.
, NCLEX Mental Health Exam 2026/2027: 80 Questions &
Answers
Section 1: Therapeutic Communication and Active Listening
Question 1
A nurse is communicating with a client in an inpatient mental health facility. Which of the
following actions by the nurse demonstrates the use of active listening?
A. Offering self
B. Use of silence
C. Attention to body language
D. Reflection of feelings
Answer: C
Explanation: Active listening involves fully concentrating on, understanding, and
responding to a speaker. Attention to body language is a core component of active listening,
as it allows the nurse to observe nonverbal cues that convey meaning beyond spoken words.
Offering self, using silence, and reflecting feelings are therapeutic communication techniques
but do not specifically define active listening.
Section 2: Bipolar Disorder and Initial Assessment
Question 2
A nurse on a mental health unit is admitting a client who has bipolar disorder. Complete the
following sentence by using the list of options.
The first action the nurse should take is to address the client's __________ due to the client's
__________.
First blank options: Urine output; Cardiovascular injury; Noncompliance with medication
therapy; Inability to focus
Second blank options: Pressured speech; Poor recall of last food intake; Constant
psychomotor activity; Lithium level
Answer: The first action the nurse should take is to address the client's cardiovascular
injury due to the client's constant psychomotor activity.
Explanation: In a client with bipolar disorder experiencing mania, constant psychomotor
activity can lead to exhaustion, dehydration, and potential cardiovascular injury or collapse.
,This physiological safety concern takes priority over psychosocial assessments. The nurse
must first address physical safety risks before proceeding with other admission tasks.
Section 3: Trauma-Informed Care and Client Teaching
Question 3
A nurse at an inpatient mental health facility is caring for a client who recently experienced a
traumatic event. The nurse is providing teaching to the client. Which of the following
statements should the nurse include in the teaching? (Select all that apply.)
A. "A support group might be helpful to you at this time."
B. "You will have minimal problems performing your daily self-care tasks."
C. "It is uncommon for people who survived a traumatic event to experience spiritual
distress."
D. "You should seek help if you have thoughts of self harm."
E. "It is common for people who survived a traumatic event to experience feelings of
anxiety."
Answer: A, D, E
Explanation: Support groups provide validation and shared coping strategies. Seeking help
for self-harm thoughts is a critical safety intervention. Anxiety is a common psychological
response to trauma. Statements B and C are incorrect because trauma frequently disrupts
daily functioning and may precipitate spiritual distress.
Section 4: Legal and Ethical Considerations in Mental Health
Question 4
A charge nurse is preparing an educational session for a group of newly licensed nurses to
review client rights under the law. Which of the following statements should the nurse make?
A. "Information regarding clients should remain confidential until after their death."
B. "Failure to report suspected maltreatment or neglect of a disabled adult is a felony in all
states."
C. "As long as client identity is disguised, their health information can be shared between
professionals on the internet."
D. "In the event a client threatens harm to others, medications can be administered without
consent."
, Answer: B
Explanation: Mandatory reporting laws in all US states classify failure to report suspected
abuse or neglect of vulnerable adults as a criminal offense, often a felony. Confidentiality
extends beyond death in most jurisdictions. Disguising identity does not permit unrestricted
online sharing of health information under HIPAA. Medications cannot be administered
without consent except in specific emergency situations, not merely for threats.
Section 5: Pharmacological Management of Schizophrenia
Question 5
A nurse is reviewing the electronic medical record of a client who has schizophrenia and is
taking clozapine. Which of the following findings is the priority for the nurse to identify to
notify the provider?
A. The client's chart indicates a 1.36 kg (3 lb) weight gain in 1 month
B. The client reports an inability to breathe easily
C. The client's laboratory results indicate a fasting blood glucose level of 130 mg/dL (74 to
106 mg/dL)
D. The client reports having recently started smoking cigarettes
Answer: B
Explanation: Difficulty breathing may indicate clozapine-induced myocarditis or
cardiomyopathy, which are life-threatening adverse effects requiring immediate provider
notification. While weight gain, hyperglycemia, and smoking (which reduces clozapine
levels) are important concerns, respiratory symptoms represent the highest priority due to
potential rapid deterioration.
Section 6: Anorexia Nervosa – Evaluation of Improvement
Question 6
A nurse is caring for a client who has anorexia nervosa. The nurse is evaluating the client
after 2 weeks. Which of the following findings indicate an improvement in the client's
condition? (Select all that apply.)
A. Bowel movement
B. Blood pressure
C. Peripheral edema
D. Skin temperature
E. Blood urea nitrogen (BUN)
